In order to optimally meet the needs of infants, children and their caregivers, the Center for Autism and Early Childhood Mental Health (CAECMH) at Montclair State University is anchored in a developmental approach that is supported by theoretical education, research-based methods and clinical application. The ways the CAECMH understands and applies infant mental health, early childhood mental health and the developmental DIR®/Floortime™ model are outlined below.
Infant Mental Health
As a field of study, infant mental health is an interdisciplinary field concerned with the optimal physical, social, emotional and cognitive development of the human infant within the context of his/her family. The process whereby an infant and parent attach, or fail to attach to each other, and the unique contributions each member of the pair makes to this dynamic yet vulnerable process constitutes the primary clinical focus of infant mental health. The infant is principally viewed within a primary caregiving relationship, usually with the mother, and this pair or dyad is the focus of assessment and intervention. As a constellation of emotional capacities, infant mental health involves the capacities that infants and children develop to:
- Self-regulate
- Experience the full range of human emotions
- Engage in loving, reciprocal relationships
- Represent the world in thought and language
- Engage in shared emotional thinking and relatedness
- Become intimate and care for others interdependently
- Engage in productive activities
Below are the principles that guide our practice of infant mental health:
Guiding Principle 1
The human infant comes into the world with remarkable capacities for human relatedness with attachment promoting behaviors (APBs) that help invite, inform and regulate relationships with his caregiver. From the earliest moments, infants require consistency, stability, predictability, availability and attuned love.
Guiding Principle 2
The period of life from birth to three years is a sensitive period of development for the formation of what we call “character” or “personality.” The greatest period of brain development, the brain “growth spurt,” occurs from the last trimester of pregnancy through the first 18 months of life. During this period, nutritional, physical, social and emotional satisfactions and failures will be “biologized,” meaning that actual changes occur in the physical/chemical structures in the brain.
Guiding Principle 3
Pregnancy and childbirth are powerful conscious and unconscious reminders in the parent of childhood issues, which can help or hinder the parent in responding to, caring for and loving the infant. In every birth, the infant can serve as a powerful transference object for the parent, meaning that thoughts, feelings and beliefs about other figures and events in the parental past can become associated and confused with the infant. Pregnancy, birth and the first two years of maternal care require the availability of psychological resources, emotional support and parent-infant psychotherapy. Parenting is a relationship, not a skill, and the belief that parenting can be “taught” in the same manner that we acquire other skills is not clearly supported.
Guiding Principle 4
We who work with infants and their parents also have our own emotional histories that influence how we work with families, especially those families where infants are not adequately cared for, or are hurt. We are not immune from the same psychological forces that influence the dyads. Infant mental health requires that these feelings be attended to. Delivery systems and child protective agencies must provide protected time for intensive and rigorous staff training and ongoing regular supervision.
Guiding Principle 5
The nature of the infant-parent relationship is best understood within the setting of the family home because the context of family events such as eating, sleeping, relating and nurturing, as well as the alternate ways parents communicate to us through pictures, objects, toys, family stories and memories, are rooted in the family home.
Guiding Principle 6
The infant-parent relationship emerges within a unique set of cultural and economic factors, which provide an historical and practical context to the family and to the intervention. Infant care, expression of affect, use of health care and relationships with interventionists are profoundly influenced by the culture and economic resources of the family.
Early Childhood Mental Health
Growth in play, cognition, relationships, emotion and communication continues during the preschool (three to six) and the early elementary (six to eight) years, the development of these capacities organized by the nature of the child’s earliest relationships. Emotional and developmental progress and their connection to the child’s relational world are the areas for assessment and intervention in early childhood mental health. Below are the principles that guide our practice of early childhood mental health:
Guiding Principle 1
If a child is preoccupied with his internal life, he/she is less available to invest the external world with interest and attention.
Guiding Principle 2
Communication and language emerge from emotional relationships, especially the parent-child relationship. Early disruptions in relatedness often are manifested in delays in language, play and other symbolic expressions. All adults who form relationships with children help influence their development.
Guiding Principle 3
When the child is able to express his thoughts, emotions, problems or conflicts in symbolic ways such as in play, gestures and language, less “acting out” occurs.
Guiding Principle 4
As children progress through infancy, the preschool years, middle and later childhood, they require “different kinds” of adults to interact with.
Guiding Principle 5
Early disruptions in attachments, early instability, trauma and deprivation often continue to manifest themselves as problems throughout life.
Guiding Principle 6
When early relationships are unhealthy, all areas of development can be affected and show delays in ability and progress.
Developmental, Individual Difference, Relationship-Based approach (DIR)
(adapted from http://www.icdl.com/dirFloortime/overview/documents/WhatisDIR.pdf)
The Developmental, Individual Difference, Relationship-based (DIR®/Floortime™) model is a framework that is tailored to the unique challenges and strengths of children with autism spectrum disorders (ASD) and other developmental challenges. The objectives of the DIR®/Floortime™ model are to build healthy foundations for social, emotional and intellectual capacities rather than focusing on skills and isolated behaviors. Central to the DIR®/Floortime™ model is the role of the child’s natural emotions and interests, which has been shown to be essential for learning interactions that enable the different parts of the mind and brain to work together and to build successively higher levels of social, emotional and intellectual capacities. The DIR®/Floortime™ model emphasizes the critical role of parents and other family members because of the importance of their emotional relationships with the child.
Guiding Principle – Developmental
Drawing in the first nine functional emotional developmental levels (FEDLs) described by Dr. Stanley Greenspan, the need to understand where the child is developmentally is critical to planning a treatment program. This includes helping children to develop capacities to attend and remain calm and regulated, engage and relate to others, initiate and respond to all types of communication beginning with emotional and social affect based gestures, engage in shared social problem-solving and intentional behavior involving a continuous flow of interactions in a row, use ideas to communicate needs and think and play creatively and build bridges between ideas in logical ways which lead to higher level capacities to think in multicausal, grey area and reflective ways. These developmental capacities are essential for spontaneous and empathic relationships as well as the mastery of academic skills.
Guiding Principle – Individual difference
Individual difference refers to the unique biologically based ways each child takes in, regulates, responds to and comprehends sensations such as sound, touch and the planning and sequencing of actions and ideas. This unique profile, addressing modulation, processing and integration of the familiar five sensory systems, as well as the vestibular, proprioceptive and kinesthetic systems, must be understood through a careful, multidisciplinary perspective in order to plan therapeutic and educational interventions. Some children, for example, are very hyper responsive to touch and sound, while others are under-reactive, and still others seek out these sensations. A child’s behaviors, including his/her “mis”-behaviors or “symptoms,” must be viewed as efforts to “communicate” the nature of a child’s developmental capacities and individual profile. In support of this knowledge, the CAECMH clinical staff will make every effort to develop a child’s “unique self-statement,” attempting to create an “I” statement on behalf of the child. This “I” component will also include insights rooted in the emerging scientific findings about the neurodevelopmental characteristics and differences in children with identifiable developmental profiles, such as children with autism spectrum disorders (ASD).
Guiding Principle – Relationship-based
Important are the learning relationships with caregivers, educators, therapists, peers and others who tailor their affect-based interactions to the child’s individual differences and developmental capacities to enable progress. “Affect” is understood as the “organizer” of development in all domains. Affective and gestural systems are understood as foundational for later language and speech, and sensitive, affective, attuned and “co-regulating” relationships are understood as pivotal to promoting self-regulation.
CREDO
This is a place
- Where all belong and are welcome,
- Where who YOU are matters,
- Where your individual differences ARE important,
- Where we will be interested, respectful and caring,
- Where your conflicts and struggles can be shared in safety,
- Where autism, and mental health concerns, and developmental concerns, and learning difficulties, and emotional concerns, and “behavioral” concerns are not seen as separate from each other,
- Where we honor and promote your potential,
- Where fun, joy and humor can live,
- Where we celebrate human development,
- In family and community,
- With dignity and peace.